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Original poster

Do I really need a smear?

137 replies

humblesims · 02/08/2017 08:09

Its that time again. The letter has come to make an appointment. I have always been responsible and had the smear test even though I hate it like everyone does.
But I'm fifty two. I dont want to go anymore. I'm menopausal. I have piles. My fanjo is not as neat as it was (I know that counts for nothing).
When does the risk of cervical cancer reduce? Will I still have to have smears when I'm in my dotage?

I know I'll go but...I'm tempted not to.

OP posts:
Laska5772 · 17/08/2017 15:54

Have to say I am the same.. Am 59 now and have declined all smears for about 7 years..the last few have been so painful since meno. I wont be going back for any nor breast checks either ( the one i went for really hurt! the nurse sort of clamped me in and i had actual bruises! ).
I do keep a look out for any changes though. but am v. l/t married have no reason to suspect my Dh of straying and no abnormalities in smears for over 20 years .

I think ill die of something else.. ( i may be wrong but its a chance ill take..) thats it for me and smears .

Slimthistime · 17/08/2017 16:00

Polly - a prostate biopsy is not the first stage of the test? They only do it if there's an issue with PSA, I thought?

Kat786 · 17/08/2017 16:00

The point I try to make about prostate is that the test is about as accurate at predicting cancer as the smear test is for women. It was decided not to offer it as a screening programme for the men because over treatment could cause them harm! But women are expected to embrace the unreliable smear test happily! And whatever any individuals take is on screening it is only recently women have been told it's a choice and they have a right to refuse. It was raised in Parliament and people were clamouring to get the sentence removed from the "invitation " letters. It's only recently women have been told they can opt out of screening and how to do it! Is it really acceptable to bully harass and mislead women into a test they might not want??

Kat786 · 17/08/2017 16:04

Yes obviously cervical cancer charities such as Jos Trust obviously don't want it advertised screening is a choice! Or that there are financial incentives for doctors to get women to screen!

wheredoesallthetimego · 17/08/2017 16:05

if you're going to get a £2700 cash bonus for getting 80% to put up with this nonsense, why wouldn't you?

FFS

most GPs I know have taken significant pay cuts over the last few years as funding is falling in both absolute and real terms. we don't get a "cash bonus" for smears, it is part of the funding that pays for things like nursing and admin staff, the cleaner, burglar alarm, heat and light for the building, insurance, couch roll, phone bill etc etc etc

terrylene · 17/08/2017 16:13

legacyscreening.phe.org.uk/prostatecancer

It was a PSA blood test they were looking at for prostate cancer.

I saw the questions in Parliament - it was an MP speaking on behalf of a cancer charity asking that the Health Secretary remove the sentence that says 'it is your choice to screen or not' Angry He said he would look into it.

PollyPerky · 17/08/2017 20:11

The point I try to make about prostate is that the test is about as accurate at predicting cancer as the smear test is for women.

No that's not the case. You are confusing the issue!

Smear tests don't predict cancer. They look for changes that may be pre-cancerous or are in rare cases already cancer.

Prostate blood tests are notoriously inaccurate. Everyone knows this. Someone in my family has just had this test done. The GP said they will discuss what to do next if the level is raised. No one goes ahead willy nilly with treatment.

You are posting as if the whole medical profession is ignorant.

It's exactly the same as the C125 blood test for women for ovarian cancer ( the 2 conditions are linked- men whose mother's had OC a
greater greater risk of OC.) C125 can be raised and yet negative and low even when cancer is present.

The point is drs and patients decide what to do with the knowledge.

You simply can't compare smear tests and blood tests for prostate cancer- totally different. One looks for pre cancer , the other for existing cancer.

Adawells · 17/08/2017 23:48

There is definitely a stepped incentive payment built into this, starting at 40% and rising by 5% increments to the target level of 80%. GPs are put under pressure to get as many women as possible to test, or it will affect their income. It means there really isn't a free choice for women.

wheredoesallthetimego · 18/08/2017 00:13

Yes but it's not a "cash bonus". It's vital money for running the practice. Miss these targets and you will find your local surgery has less services to offer you.

HorridHenryrule · 18/08/2017 00:26

Is the HPV vaccine any good and if my dd was to get that done this year would that mean no smear tests.

HorridHenryrule · 18/08/2017 00:29

I have heard of side effects on teenage girls after having the HPV vaccine. I was wondering what everyone else has heard about it?

WiganPierre · 18/08/2017 00:51

HorridHenryrule I haven't had the HPV vaccine personally so I don't know too much about it but I believe the vaccine doesn't protect you from all strains of HPV. Remember HPV is sexually transmitted. Melinda Messenger did some interviews recently about how she wouldn't let her daughter have the vaccine as it has been suggested there are side effects and some deaths, but it is unknown whether there is a definite link; please do your research! The HPV vaccine is optional, however.

WiganPierre · 18/08/2017 00:53

I've enjoyed reading this thread. I opt out of smear tests and will probably opt out of breast screening, too. I feel that doing breast self exams at home is enough for me.

HorridHenryrule · 18/08/2017 01:33

Thanks for answering my post I will do my research but its nice to know that I'm not the only one worried about it. It is a big decision.

sandgrown · 18/08/2017 06:48

I work on a team of eight women. Three of them have had breast cancer discovered by screening. One very early stage had minimal treatment. One had a mastectomy and has managed to avoid chemo by trialling a new drug. The third one had delayed having screening due to other health problems. When she finally went they found a large tumour. She is having months of chemotherapy which will be followed by a mastectomy. She bitterly regrets not being screened earlier.

Kat786 · 18/08/2017 07:31

My daughter would have been one of the first cohort to get the jab but I refused consent. I could not find any randomised controlled trials and it was rushed through so fast I couldn't find any reports about safety. As it only protects against a few strains of HPV then yes smears are still necessary or should I say HPV smear. Gotta keep people in jobs after call! Then they were arguing about how long protection lasted and how many doses to give! I decided my daughter was too precious to be a guinea pig..she also has her own health issues to throw into the mix. Since then we have watched report after report of girls lives changed forever by this vaccine...
Also as HPV is a virus I wonder if by vaccinated against a few nasty strains other strains will mutate to take their place and then what will big pharma do..

Kat786 · 18/08/2017 07:43

I'm sorry..I obviously phrased that wrongly. The hype around screening would say it's to be expected as I'm classedxasxs lower sociology economic women and we don't tend to go for screening. Another thing about the programme I hate. As you say the smear sometimes detects changes which could become cancerous. However it's not even particularly good at that in my opinion. It's about as accurate in detecting these changes as the PSA test is.
Incidentally a blood test was developed very quickly after a lot of men found the finger up the bum unacceptable. ..however we are TOLD we should find smears acceptable and should just grow up...

mogulfield · 18/08/2017 07:47

Having seen a friend die at 29 from cervical cancer (she'd missed her smear) I always go.
3 minutes of mild discomfort every 5 years is a no brainer.

PollyPerky · 18/08/2017 08:17

Kat I know you mean well by your posts but it's important to state facts and not present your opinion as facts.

. As you say the smear sometimes detects changes which could become cancerous. However it's not even particularly good at that in my opinion. It's about as accurate in detecting these changes as the PSA test is.

So where have you found this information?

Incidentally a blood test was developed very quickly after a lot of men found the finger up the bum unacceptable

Again- where does it say this?
Men have both!. If a man presents with prostate issues the first thing their GP does is a rectal exam to check the size. Then a blood test if necessary.

You are entitled to your choice over smears and mammos. But some of your points are dubious in their accuracy to say the least!

I think the post by sandgrown says it all, very clearly, and replicates what I said earlier about early detection = less treatment not necessarily different long term outcomes re. deaths.

Anyone can refuse treatment for anything at any point. It's not mandatory.

Kat786 · 18/08/2017 12:31

Speaking personally I work full time and pay tax and NI. I thought this paid for things like the NHS. Since I do pay tax and NI I would love to see my doctor and discuss the medical issues I DO have but even after opting out of smears my cervix is still the thing they're most worried about. I swear I could present with a pain in my right big toe and be told I need a smear!

terrylene · 18/08/2017 13:50

The whole point of screening is that you find changes before they become a big problem. So the ones that would have had major treatment will get less treatment.

However a whole load of people are treated who would not have had treatment. So they are not getting less treatment.

It is not the same for everyone.

Kat786 · 18/08/2017 15:23

But changes are just that in smears..changes! They could go back to normal on its own but as yet it's not certain what will or won't so treat ment is automatically offered! Personally for me less is best when it comes to medical care. I look after myself and don't think I'm a cancerous time bomb because I'm a woman. But everyone is different and I respect that

PollyPerky · 18/08/2017 16:23

what I don't understand about the 'no screening' argument, is that the result does not mean treatment is forced on anyone. With smears there is a watch and wait option for stages of changes. For mammos there is a watch and wait or decline treatment for DCIS especially. This is not new; I've heard women in their 80s who had DCIS and decided to decline treatment on the basis the odds were 50-50 invasive in time.

Doctors are people! They listen and it's a partnership with the patient. if it's not and communication over the woman's wishes is not listened to, find another dr!

Kat786 · 18/08/2017 17:56

Sadly PollyPerky doctors are Not all people. I know women who avoid medical care at all costs because of the pressure to have a smear. The Internet carries lots of similar accounts. It can't all be one big conspiracy theory! I opted out of smears in 2015. The law states an opted out woman should no be longer asked about screening. I am! Some surgeries ask women when their last smear was and ask them to sign a paper promising to keep up to date with all screening as a condition of being accepted on their books! I opted out in 2015 and have NEVER asked for contraception or an abortion or for treatment for an STI but still I'm hassled about smears every visit...

Kat786 · 18/08/2017 18:04

To clarify I know smears don't depend on contraception or abortion but most cc cases are HPV based which is an STI. I am just exasperated about the way women are treated over screening!